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General NPI Number Information
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NPI Number | 1598430340
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Entity Type | Individual
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Provider Name | SARAH SKODACK WINTER ACNPC-AG
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Gender | Female
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 6201 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-0001
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Country | US
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Telephone | 940-206-0982
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 BROADWAY AVE APT 7311
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City | FLOWER MOUND
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State | TX
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Zip | 75028-7663
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Country | US
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Telephone | 940-206-0982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1048033
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License Number State | TX
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